How Does The Insurance Company Determine The Pain And Suffering Part of a Settlement?

Car accidents are some of the most stressful things life can throw at you. In addition to property damage and medical expenses, pain and suffering can be taken into account when assessing the value of your legal claim. Keep in mind, though, that this is, generally, one of the most difficult parts of the case; you will need a skilled lawyer well-versed in personal injury law to win your case.

In this article, our personal injury lawyers discuss the ways pain and suffering is determined by insurers and the courts. We also explain the steps you can take to protect your personal injury claim.

Pain and Suffering are Considered Part of General Damages

General damages, also known as non-economic damages, reflect the intangible losses you have suffered because of the accident. Pain and suffering is the most recognizable of the non-economic damages an injury victim may claim.

There are two types of pain and suffering that accompany injuries from accidents:

• The first is the physical pain and suffering one suffers; this is the more obvious of the two.
• The second type is the mental anguish accident victims suffer. Unfortunately, this part is more difficult to prove, because these injuries are not as readily apparent as physical ones.

If the injury is less obvious, as with mental anguish, seeking compensation for this loss in your quality of life becomes more difficult. Without a good attorney who is knowledgeable of your state’s laws, the insurance company may deny mental anguish in the pain and suffering aspect of your personal injury claim.

Our attorneys understand that mental suffering is very real. It is as real as a broken bone. If you are hurting, both physically and mentally, due to an accident or car wreck, reach out to us today for your complimentary case evaluation. We are on your side. Let us fight for you!

How Does the Insurance Company Determine Pain and Suffering?

Insurance companies typically rely on one of two standard methods to determine pain and suffering:

The Multiplier Method

The first is the multiplier method, which takes your total economic damages, such as medical bills, lost wages, and other documented costs, and multiplies that number by a factor based on the severity of your injury, typically ranging from 1.5 to 5. A minor soft tissue injury might receive a low multiplier, while a severe, long-term injury like a fracture or traumatic brain injury could justify a multiplier closer to 5.

The Per Diem Method

The second is the per diem method, which assigns a fixed dollar amount to each day you experience pain and suffering, often based on your daily wage, then multiplies that rate by the number of days from your injury through your recovery. This method tends to work best for injuries with a clear, defined recovery period.

Both Processes Are Often Handled by a Program

Many major insurance companies don’t perform this math by hand. Instead, they feed your claim details into proprietary software, most commonly Colossus, which assigns a severity score to your injuries based on medical codes and other claim factors, then generates a recommended settlement range.

Insurance adjusters are sometimes restricted from exceeding what this software recommends, regardless of the specific circumstances of your case.

Insurers Are Not on Your Side

When insurance companies start to review a claim, they always look to see if you got prompt medical attention soon after your accident. They operate under the assumption that if you did not seek medical care, you must not be in pain (and that the onset of pain was not caused by the accident).

This is one of the reasons you should always get medical help immediately after any accident. Do not assume that everything is fine. You might not be. Between adrenaline masking pain or obscure injuries that may take days to manifest, you could be suffering without knowing and only through a proper diagnosis could your injuries become apparent.

ALWAYS seek medical attention after any accident. It will protect your health and the strength of your case.

What Happens If You Don’t Go to the Doctor

If you do not go to the doctor after the accident, the insurance company will move forward as if there is no pain and suffering. It can be a legal uphill battle to get any damages, whether it is medical expenses, lost wages, or pain and suffering, added to your financial compensation package if there is no initial medical documentation or even a delay in medical attention.

However, if there is medical documentation, it is extremely difficult for an insurance company to ignore. They may attempt to give you less than you deserve, but with an accident lawyer from our law firm, we will make sure they give you what you are legally entitled to receive.

The likelihood of positive results is better with immediate medical documentation.

Insurers Are Looking for Ways Not to Pay

Insurance companies are highly concerned about their bottom lines, so they will look for any reason to discount your claim of pain and suffering. Therefore, it is always best to be honest, especially with your doctor. Do not try to overstate your suffering.

If you are in pain, be proactive and get the medical documentation that proves your injury. We will work with you to make sure your recovery is the best it can be.

Steps to Strengthen Your Pain and Suffering Claim

Regardless of how you feel after your accident, always get prompt medical attention. This is the best thing to do for your physical well-being as well as your legal well-being. It provides documentation for your injuries and makes it harder for the insurance company to give you less than what you deserve.

Beyond your medical records, keeping a pain journal can make a real difference in a pain and suffering claim specifically. Each day, write down:

• Your pain levels from 1 being the lowest to 10 being the highest
• How well and how long you slept the night before
• Medications you took
• Limitations on your activity, whether that’s picking up your kids or going to work

Unlike a medical bill, pain and suffering has no receipt attached to it, which is exactly why this kind of day-to-day record becomes evidence in its own right.

What to Avoid While Your Claim Is Pending

Certain actions after your accident can inadvertently hurt the value of your pain and suffering claim, even when you’re not trying to do anything wrong.

For example, insurance companies and defense investigators routinely look through a claimant’s public social media posts, searching for anything that contradicts the severity of the injury being claimed. A photo from a friend’s wedding, a check-in at the gym, or even an innocent comment like “feeling good today” can be used to argue your injuries aren’t as serious as you say.

The safest approach is to avoid posting about your activities, your recovery, or the accident itself until your claim is resolved.

Does Your State Cap Pain and Suffering Damages?

Whether there’s a limit on what you can recover depends entirely on where your accident happened. For example,

• California: No cap for standard personal injury claims
• Idaho: Capped at $250,000, adjusted annually for inflation (currently over $500,000)
• Washington: No cap; courts ruled such limits unconstitutional
• Kentucky: No cap; the state constitution prohibits damage caps entirely

Idaho is the outlier of the four, which makes legal representation in that state especially valuable.

Call Sargent Law Firm Injury Lawyers to Determine Your Pain and Suffering

If you have been involved in an accident, reach out to Sargent Law Firm Injury Lawyers today! Our highly trained team is ready and willing to take on any insurance company to make sure you get the financial compensation that you are legally entitled to receive.

Call today.